Swedish private-sector employees' experiences of promoting and hindering factors for working while having mental health problems: A qualitative study.

Three overarching themes emerged from the thematic analysis of employees' experiences of working while having mental health problems.

• The three themes were: influence of life stage on working while having mental health problems; managing mental health problems in the social and organizational context; and preserving one's identity and agency when working while having mental health problems.
• Reflexive thematic analysis was used to analyze the data from semi-structured interviews.
• 18 private-sector employees participated in the study.
• Participants were eligible if they scored ≥3 on the General Health Questionnaire or answered yes to a question on self-predicted sickness absence in the coming year due to common mental disorders.

Promoting and hindering factors for working while having mental health problems occurred at multiple levels: individual, group, leader, and organizational.

• Promoting factors included social support from colleagues, a trusting relationship with the first-line manager, and engaging in leisure-time physical activity.
• Hindering factors included perceiving the cause of symptoms to be primarily outside work, a cold or noisy work environment, and schedule mismatch.
• The multi-level nature of these factors spans individual, group, leader, and organizational levels.

Employees who perceived the cause of their mental health symptoms as related to their private life tended not to seek help from the workplace, despite the impact on their work.

• This perception of symptom causation as primarily outside work was identified as a hindering factor.
• This perception led to delayed access to help.
• The authors note this should be considered in the development of future interventions.

Social support from colleagues was identified as a promoting factor for working while having mental health problems.

• Colleague support was identified as operating at the group level.
• Fostering a supportive and inclusive work environment where there is space for enjoyment was identified as helping employees manage mental health problems at work.
• This finding emerged from semi-structured interviews with 18 private-sector employees.

A trusting relationship with the first-line manager and having an active and present manager were identified as promoting factors for working while having mental health problems.

• Manager-related factors operated at the leader level.
• Having an active and present manager was specifically highlighted as a promoting factor.
• Reasonable production goals, also linked to managerial and organizational context, were identified as an additional promoting factor.

Leisure-time physical activity was identified as a promoting factor for working while having mental health problems.

• This factor operated at the individual level.
• Leisure-time physical activity was identified alongside social support from colleagues and a trusting relationship with the first-line manager as key promoting factors.
• This finding emerged from reflexive thematic analysis of semi-structured interviews with 18 employees.

A cold or noisy work environment and schedule mismatch were identified as hindering factors for working while having mental health problems.

• These factors operated at the organizational level.
• They were identified alongside perception of symptom causes as primarily outside work as key hindering factors.
• These environmental and scheduling factors were identified through semi-structured interviews with 18 private-sector employees.

The study supports a life-course perspective on understanding how employees experience promoting and hindering factors for working while having mental health problems.

• One of the three themes specifically addressed the influence of life stage on working while having mental health problems.
• The authors state that 'our study supports a life-course perspective on the understanding of how employees experience promoting and hindering factors for working while having mental health problems.'
• The study was conducted with 18 private-sector employees in Sweden using qualitative methods.